The efficacy of drugs in the management of endometriosis

Carlo Bulletti, Bulletti C, C Bulletti, Flamigni C, C Flamigni, Polli V, V. Polli, E Giacomucci, Evaldo Giacomucci, Giacomucci E, A Albonetti, Albonetti A, Negrini V, V. Negrini, Andrea Galassi, Galassi A, A Galassi, Morselli-Labate AM, Antonio Maria Morselli‐Labate, A M Morselli-Labate
The Journal of the American Association of Gynecologic Laparoscopists · 1996 · vol. 3(4) , pp. 495–501 · doi:10.1016/s1074-3804(05)80157-4 · PMID:9050678 · W2087913333
Other OA: closed CC0 ⤵ 15 in-corpus citations
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This review synthesizes evidence on the efficacy of various drugs, including hormonal therapies and analgesics, for managing endometriosis symptoms and progression.

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Abstract

STUDY OBJECTIVE: To establish the crude effects of danazol and gonadotropin-releasing hormone (GnRH) analogs in the management of endometriosis. DESIGN: Prospective case-control study. SETTING: Unit of the Pathophysiology of Reproduction outpatient department. PATIENTS: Two groups of 110 women each with endometriosis (American Fertility Society score 1-3) who received danazol and GnRH analogs, and a control group who did not receive any drugs. INTERVENTIONS: Women in the treatment groups received danazol 200 mg every 8 hours for 6 months, or a different GnRH agonist at standard dosages for 6 months. Laparoscopy was performed twice, at the time of diagnosis and just before the end of treatment (or no therapy for controls). Surgical treatment of the implants was performed at the second laparoscopy. MEASUREMENTS AND MAIN RESULTS: Samples of both eutopic and ectopic endometrium were collected during both laparoscopies. Both danazol and GnRH agonists were useful in reducing the AFS scores to inactive endometriotic implants, and there were no significant differences between the effects (p <0.001). Fibrosis was found after 6 months of observation in the implants in one control woman (0.9%), in 20 patients (18.2%) treated with danazol (p <0.001 vs controls), and in 4 patients (3.6%) treated with GnRH agonists (NS vs controls). A correlation between a clinical diagnosis of AFS score zero and histologic features of fibrosis in the ectopic specimens after therapies was observed in 28% of women, with poor agreement (k = 0.07). CONCLUSIONS: Fibrosis, which represent the absence of endometrial cells within the specimens of endometriotic lesions or eutopic endometrium, did not appear in eutopic endometria but it was found in some endometriotic implants. Danazol and GnRH agonists reduced the clinical AFS scores of endometriosis, but their histologic effects in completely and permanently eliminating endometriotic implants were unacceptable.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Adolescent Adolescent Adult Adult Case-Control Studies Case-Control Studies Danazol Danazol Danazol Endometriosis Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium Estrogen Antagonists Estrogen Antagonists Estrogen Antagonists

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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